Transcranial Magnetic Stimulation and Psychological Therapies: A beneficial Combination?
Shane Gill, Patrick Clarke, Ashlee Rigby and Cherrie Galletly
World Journal of Medical Research 2014, 3:7
Repetitive TMS (rTMS) has been found to be an effective treatment for major depression. A number of psychological therapies have also been shown to be effective. We hypothesised that the efficacy of rTMS could be increased by combining this treatment with psychological therapies in an Enhanced rTMS program.
Within a clinical rTMS service, we designed a pilot study to evaluate the effects of combining rTMS and psychological therapies, having already delivered rTMS alone for previous patients.
Materials and methods
In an Enhanced rTMS program, patientsattended a half day program, which included both psychological therapies and a session of rTMS, three days a week, for six weeks. The program included mindfulness based cognitive therapy, problem-solving therapy, computerized Cognitive Behavioural Therapy, exercise, and relaxation. The outcomes of the combined program were compared with patients who previously received only rTMS.
A total of 18 people commenced the Enhanced rTMS program, with 14 completing the program. Patients who completed the full program showed a similar improvement in depressive symptoms to those treated with rTMS alone (59 patients), suggesting that there may be limited advantage in adding psychological therapies.
The addition of psychological therapies to rTMS did significantly not improve the rate of beneficial outcomesin comparison to rTMS alone; however the sample size was relatively small. There was low adherence to the full program in some patients, with some preferring to attend only certain program components.
neurostimulation, CBT, exercise, mood disorders, problem solving therapy